👁️‍🗨️Eyes on the Future: How Eye-Tracking Could Transform Early Dementia Detection

Our eyes may hold the key to unlocking the earliest signs of dementia. Researchers are increasingly turning to eye-tracking technology as a non-invasive, objective method.

Unlike standard cognitive tests such as Mini-Mental State Examination (MMSE) or Montreal Cognitive Assessment (MoCA), which depend on language and education level, eye tracking measures involuntary eye movements—fixations, saccades, smooth pursuits, and pupil responses—providing objective, language-independent insights into brain function. These patterns often change in the earliest stages of Alzheimer’s disease and mild cognitive impairment (MCI), suggesting possible alterations in attention, working memory, and executive control.

Why Eye Movements Matter

Eye movements are tightly linked to brain networks controlling attention and memory. In early cognitive decline, patients may struggle to maintain focus, ignore distractions, or correct gaze errors. Research shows that eye tracking has even shown potential to distinguish between two major subtypes of mild cognitive impairment (MCI):

• Amnestic MCI (aMCI) primarily affects memory. Individuals often show slower eye movements and less efficient visual search, reflecting difficulties in encoding and retrieving information. These changes suggest early dysfunction in hippocampal and related memory circuits.

• Non-amnestic MCI (naMCI) impacts attention, executive function, or language rather than memory. These individuals may exhibit impulsive saccades, poor gaze control, and more frequent errors when shifting attention, indicating deficits in frontal and parietal networks responsible for planning and inhibitory control.

This ability to distinguish between subtypes provides clinicians with deeper insight into which brain systems are affected and may help predict progression toward Alzheimer’s disease or other dementias.

From Lab to Clinic and Home

In PREDICTOM clinical study, we integrate and redefine how eye tracking moves beyond research into real-world healthcare. The eye tracking tests are scalable, accessible, and they have two tests:

• Gamified Home Screening: This study represents one of the first large-scale clinical deployments of eye tracking integrated into interactive, game-like tasks on tablets and laptops using standard webcams. This innovative approach aims to make cognitive screening more engaging and accessible, allowing up to 4,000 participants to monitor aspects of brain health from home without specialized equipment.

• High-Precision Clinical Testing: If the participants are invited for further clinical testing, PREDICTOM will use high-precision eye-tracking systems capable of capturing fine-grained gaze and pupil dynamics. These brief, approximately 12-minute sessions are designed to detect subtle changes in attention and visual processing, making the protocol practical for use in general practice and clinical settings.

The protocol will evaluate whether it can detect early cognitive changes and help differentiate subjective cognitive complaints from mild cognitive impairment — a critical step toward personalized risk assessment.

By combining consumer-friendly technology with advanced neuroscience, PREDICTOM positions eye-tracking as a complementary, investigational digital biomarker rather than a diagnostic tool. This approach aims to support existing clinical assessments and contribute to the development of scalable methods for earlier and more accessible detection of cognitive changes.

Promise and Challenges

Eye-tracking is not yet a standardized diagnostic tool, but evidence is mounting. Certain metrics—such as saccade speed, gaze control, and pupil response—are emerging as digital biomarkers of early brain changes. Standardization and regulatory validation remain hurdles, but the technology’s portability and affordability make it a strong candidate for future screening programs.

Who is contributing eye-tracking test?

JOANNEUM RESEARCH DIGITAL from Austria is contributing eye tracking tests in PREDICTOM clinical study. The team for digital biomarker detection is led by Lucas Paletta with the aim of bridging cutting-edge neuroscience with everyday technology.

Our eyes don’t just see—they reveal how the brain works and how it changes over time.